title: Transarterial embolization of metastatic mediastinal hepatocellular carcinoma.
abstract: This paper introduces an innovative treatment for extra-hepatic metastasis of hepatocellular carcinoma. A 71-year-old patient had a stable liver condition following treatment for hepatocellular carcinoma, but later developed symptomatic mediastinal metastasis. This rapidly growing mediastinal mass induced symptoms including cough and hoarseness. Serial sessions of transarterial embolization (TAE) successfully controlled this mediastinal mass with limited side effects. The patient's survival time since the initial diagnosis of the mediastinal hepatocellular carcinoma was 32 mo, significantly longer than the 12 mo mean survival period of patients with similar diagnoses: metastatic hepatocellular carcinoma and a liver condition with a Child-Pugh class A score. Currently, oral sorafenib is the treatment of choice for metastatic hepatocellular carcinoma. Recent studies indicate that locoregional treatment of extra-hepatic metastasis of hepatocellular carcinomas might also significantly improve the prognosis in patients with their primary hepatic lesions under control. Many effective locoregional therapies for extrahepatic metastasis, including radiation and surgical resection, may provide palliative effects for hepatocellular carcinoma-associated mediastinal metastasis. This case report demonstrates that TAE of metastatic mediastinal hepatocellular carcinoma provided this patient with tumor control and increased survival time. This finding is important as it can potentially provide an alternative treatment option for patients with similar symptoms and diagnoses.
authors.affiliation: Department of Gastroenterology and Hepatology, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Chen
authors.forename: Hong-Zen
authors.initials: HZ
authors.lastname: Yeh
authors.forename: Chi-Sen
authors.initials: CS
authors.lastname: Chang
authors.forename: Chung-Wang
authors.initials: CW
authors.lastname: Ko
authors.forename: Han-Chung
authors.initials: HC
authors.lastname: Lien
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Wu
authors.forename: Siu-Wan
authors.initials: SW
authors.lastname: Hung
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D004621:Embolization, Therapeutic; D004998:Ethiodized Oil / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008479:Mediastinal Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004998:Ethiodized Oil
keywords: Embolization; Endosonography; Hepatocellular carcinoma; Lymphatic metastasis; Mediastinal neoplasm